Biomedical subjects
Publications and source records attributed to C H Chan.
We have reported a case of pancreatic ascites that responded to low-dose radiation. Our review of the literature and of the limitations of various treatment methods available suggests that low-dose radiation may have a role in the treatment of patients who are at high risk for surgery.
Respiratory dyskinesia consists of involuntary movements of the respiratory musculature and manifests as irregular respiratory rate, tachypnoea and grunting. It is probably an underrecognized condition and hence is easily misdiagnosed. Two patients with respiratory dyskinesia are reported. One patient was misdiagnosed as suffering from generalized anxiety disorder and the second as having chronic obstructive airway disease. Features useful for clinical differentiation are discussed.
A retrospective study of 83 cases of tuberculous pleural effusion showed that the mean age of the patients was 44 years and 10 patients (12%) were over the age of 70. Pleural fluid was smear positive for tubercle bacilli in none but culture positive in 23% of the cases. Pleural biopsy was a more sensitive method of diagnosis with granulomatous inflammation seen in 97% of cases. Five patients developed significant pleural thickening during chemotherapy requiring decortication. Twenty-two patients with tuberculous effusion diagnosed and treated over 2 years previously were traced for reassessment. None of them had significant pleural thickening and lung function tests did not show significant impairment compared to matched control subjects.
Soluble interleukin-2 receptor (sIL-2R) is a marker of T lymphocyte activation. We measured the amount of serum sIL-2R in 35 patients with active tuberculosis before the initiation of antituberculous treatment. Twenty had pulmonary parenchymal lesion, 8 had tuberculous pleural effusion, and 7 had tuberculous lymphadenitis. The serum sIL-2R values were markedly elevated in patients with pulmonary tuberculosis (parenchymal lesion and pleural effusion) compared with patients with tuberculous lymphadenitis (2,612 +/- 536 versus 538 +/- 121 U/ml, p = 0.023), old, inactive tuberculosis (335 +/- 23 U/ml, p = 0.001), and normal control subjects (376 +/- 38 U/ml, p = 0.001). No significant difference was found between patients with parenchymal lesion and those with tuberculous pleural effusion. There was a positive correlation between serum sIL-2R values and the extent of disease on chest radiograph (r = 0.58, p less than 0.001). We conclude that the amount of sIL-2R may be a useful marker of disease activity and extent of involvement in patients with active tuberculous lesions.
In order to evaluate the effectiveness of 1% gamma-BHC emulsion against head louse infestation, 1,527 school children were examined using observation by ocular and combing methods were used and infested children were treated with three regimes of 1% gamma-BHC emulsion. An overall infestation rate of 40% was found. The infestation rate was highest in Tung-Kuang Primary School (59%) and lowest in Chien-Hua Primary Schools (7%). The rate was highest among school children grade 2 (45%) and lowest in grade 3 (35%). The rate of girls (65%) was much higher than that of boys (9%). A total of 443 lice were collected from 78 infested school girls: 56 males, 59 females, and 328 nymph. The average number of head lice in each infested girl was 5.7. Follow-up examination was conducted one week after treatment. The cure rates for dosages of 10.0 ml, 5.0 ml, and 2.5 ml 1% gamma-BHC emulsion were 96%, 88%, 68% for girls and 100%, 92%, and 33% for boys, respectively. Only mild and transient itching and burn sensation of scalp were reported by a few children. The overall infestation rate 5 months (April-September 1981) after treatment was 23% (286/1,245). The rate of girls decreased from 65% to 40% and that of boys from 9% to 3%. Results of the present study indicates that 1% gamma-BHC emulsion is an effective pediculicide at a dosage of 5 ml or 10 ml. However, the overall infestation rate remained high (23%) 5 months after treatment. These findings suggest that treatment of head louse infestation must be conducted continuously.
Two patients with pulmonary tuberculosis developed cutaneous vasculitis after antituberculosis treatment and a patient with tuberculous lymphadenitis developed vasculitis at presentation before drug therapy. The cutaneous vasculitis probably represented immunological reactions to tubercle bacilli and/or rifampicin with antibodies and immune complex formation.
Eighty-seven patients with a carcinoma in a polyp were reviewed over a 12-year period. Ten histologic criteria were analyzed for an association with the presence of residual carcinoma. Four factors were identified as having prognostic value: size greater than 1.5 cm, sessility, cancer of at least 50% of the adenoma volume, and invasive carcinoma. Polypectomy alone is adequate treatment unless the carcinoma invades deeper to the muscularis mucosa and is associated with one or more of these characteristics.
Explore the source record for details and available documents.
This is a report on hepatic adverse events associated with dantrolene therapy. All cases reported to the manufacturer are included, from all sources, through 1987. Of 122 cases containing sufficient data to analyze, 47 patients had asymptomatic transaminase elevations, 12 had additional mild (less than or equal to 2.5 mg/dl) hyperbilirubinemia, 36 had jaundice, and 27 patients died. There is an overrepresentation of women over 35 years and patients with multiple sclerosis in the fatal group compared with the study population as a whole (not statistically significant). Mean dantrolene dose was 582 mg/d in fatal cases and 263 mg/d in the nonfatal group. Generally, at least 2 months of therapy was given before injury occurred. Concomitant drugs and nonhepatic, drug-independent disease were associated with a fatal outcome. Serum bilirubin may be predictive for death (mean of 17.0 mg/dl in the fatal group compared with 6.5 mg/dl in nonfatal cases). Of available biopsy reports, 68% included chronic active hepatitis or precirrhotic/cirrhotic lesions. Physicians should monitor liver function in patients taking dantrolene.
In order to determine how many consecutive perianal examinations can increase the accuracy of the diagnosis of enterobiasis, nursery and kindergarten children were examined with 8 consecutive scotch-tape perianal swabs. Primary school students were examined with 4 consecutive swabs, while junior high school students were examined with one swab in the morning and another in the afternoon. The positive rates among nursery and kindergarten children increased from 17.3% and 34.6% by a single swab to 44.4% and 70.2% by 8 consecutive swabs respectively. Significant differences in rates among kindergarten children by class were found by 4 to 8 swabs (3rd year class 65.6-78.7%, 2nd year class 50.3-61.1%, 1st year class 52.3-69.5%). The rate among primary school students increased from 59.9% by a swab to 77.3% by 4 consecutive swabs. Significant differences were found among the rates by grade. The highest was detected in grade 3 and lowest in grade 6. There was no significant difference between the positive rates among junior high school students obtained in the morning (33.7%) and in the afternoon (31.3%), and also no significant difference among rates by junior school was found. There was no significant difference between positive rates by sex in kindergarten children (boys, 68.8%, girls, 71.9%) and primary school students (boys, 76.8%; girls, 77.9%). However, the positive rate of junior high school girls (47.3%) was significantly higher than that of junior high school boys (37.4%).(ABSTRACT TRUNCATED AT 250 WORDS)
A 31-year old male presented with bone pain, polyuria and a palpable nodule in the neck. Radiological examination showed generalised osteopenia, subperiosteal erosion and presence of bilateral renal stones. The essential chemical pathological changes were increased plasma calcium, mid-molecule immuno-reactive parathyroid hormone (iPTH), human chorionic gonadotrophin (hCG) levels. Surgical excision of the nodule revealed a parathyroid carcinoma. The uniqueness of this case is the steroid-suppressible plasma calcium, iPTH, and hCG levels. The diagnostic implications of the findings are discussed.
To examine the need for preventive and treatment interventions, a prevalence study was conducted to ascertain the rate of depressive symptomatology and other negative mood states among 112 first-year residents. The participation rate was 54%. Subjects (N = 61) were administered the Beck Depression Inventory and Profile of Mood States in personal interview sessions. The Profile measures five negative mood states, namely, "tension-anxiety," "depression-dejection," "anger-hostility," "fatigue-inertia," "confusion-bewilderment," and one positive state, "vigor-activity." A 15.5% rate of depression was found, which is lower than a rate of 23.5%, also measured by Beck's inventory, among a sample of university undergraduates and 19.9% among an adult sample from the general population. No differences were observed among residency programs or sex on Beck's scale; however, significantly higher scores were found for women on the "depression-dejection" dimension of the Profile. The mean scores on all negative mood dimensions of the Profile were below the mean for university undergraduate norms. Neither sleep nor hours worked over the past week were associated with increased Beck scores. These results indicate that sleep deprivation and long work hours did not contribute to depression among the subjects who participated in the study. Female interns, however, appear to be at increased risk of depression, and adequate support systems need to be provided.
From May 1981 to March 1984, consecutive surveys with Scotch tape perianal swab for enterobiasis were conducted among school children in 8 primary schools in the Nanao District, also involved were 1 junior high and 8 primary schools from the Tatung District, Ilan County, Northeast Taiwan. Field treatments with mebendazole (10 mg) or albendazole (400 mg) were also conducted following 9 periods of screening for pinworm. Prior to treatment, the infection rates in Nanao and Tatung were 14.1% and 8.3%, respectively. These rates were reduced to 0.4% and 1.1% by March 1984, respectively. Throughout the study, significantly higher infection rates were generally found during the months of September, November, and December and lower rates were obtained in June. There was no difference between the infection rates of aboriginal school boys and girls. The results of the present study indicate that monthly chemotherapy is the best method for controlling pinworm infections in these mountainous regions.
The response to tricyclic antidepressants (TCAs) is studied in 75 of 121 depressed patients classified as psychotic or nonpsychotic subtypes by Research Diagnostic Criteria. Response was assessed by a clinical global evaluation scale. Of the 75 patients treated with TCAs, 40 (68%) of the nonpsychotic subtype responded in contrast to only 4 (25%) of the psychotic subtype. Adjusting for the effects of chronicity, sex, age, incapacity, agitation, retardation, endogenicity, and the unipolar-bipolar distinction as covariates, it was found that these variables failed to alter the differential response rate of the psychotic and nonpsychotic depressed groups. A literature review of 1054 patients revealed that 67% of the nonpsychotic depressed patients responded to TCAs compared with only 35% of the psychotic depressed patients.
Thirteen patients with systemic mast cell disease were studied in order to define the hepatic changes in this disease and to correlate the histologic lesions in the liver with the clinical findings. These patients often presented with multisystem disorders and 10 had hepatomegaly. Microscopically, the liver tissues in all patients showed fibrosis and chronic inflammatory cellular infiltration with plasma cells, lymphocytes, eosinophils, and mononuclear fibroblast-like cells in the portal area. The hepatic sinusoids were not significantly involved. A histologic diagnosis of systemic mast cell disease is seldom entertained in liver biopsy specimens embedded in paraffin and stained with hematoxylineosin, but can be facilitated in biopsy specimens embedded in plastic such as methacrylate. Tissue mast cells in the cellular infiltrate can be demonstrated best by special staining techniques with Giemsa, toluidine blue, and chloroacetate esterase. The severity of the histologic changes in the liver does not correlate well with the size of the liver or biochemical changes in the blood. Abnormal serum biochemical values were noted primarily in those with dehydration caused by diarrhea and vomiting, and in those with malnutrition. Hepatic function test results were usually normal, except for alkaline phosphatase level, which was elevated in all 13 patients. Although the clinical significance of hepatic involvement in systemic mast cell disease cannot be established with certainty in this study, it is believed that the prognosis of systemic mast cell disease is most intricately related to the systemic effects of mast cell involvement in many other organs, and not to hepatic involvement per se.
Explore the source record for details and available documents.
Taeniasis is a major public health problem among the aboriginal populations on Taiwan, and is highly prevalent and wide spread in the mountain areas of 10 Counties. Over 27,000 cases of tapeworm infection are estimated influencing the health and economy in the endemic areas. A treatment of taeniasis with mebendazole and praziquantel followed by a re-treatment with atabrine has been done in the field trial, and confirmed that praziquantel is highly effective agent against tapeworm infection, but mebendazole is not. Based upon experiments reported here praziquantel in a single dose of 150 mg, and 450 mg are highly effective against taeniasis and hymenolepiasis respectively.
A randomized single-blind clinical trial was conducted to compare the effectiveness and acceptance by patients of a new oral balanced lavage solution with those of a standard preparation for cleansing the colon for barium enema (50 patients) and colonoscopy (20 patients). The quality of preparation was comparable for the 2 preparations. For colonoscopy, Golytely preparation resulted in slightly better results than standard preparation. Patient acceptance was comparable for the 2 preparations. We conclude that Golytely can be used as an alternative to standard preparation for barium enema. For colonoscopy, it is slightly superior to standard preparation.